Excessive alcohol consumption is known to adversely affect health and to increase health care costs. Less is known about the potential impact of lower levels of drinking on health, the use of health care services, and health care costs. In particular, little is known about the impact of drinking that exceeds recommended limits, but is not sufficient to meet criteria for alcohol dependence. People in this group are sometimes referred to as hazardous (or risky) drinkers because their quantity and frequency of drinking is causing, or is likely to cause, problems but they aren't considered medically dependent. By the weight of their numbers, these drinkers constitute the largest proportion of society's alcohol problem. This study examines the relationship between risky drinking and health outcomes, health care utilization, and costs among primary care patients in a large managed care system. The study will inform research on the role of alcohol in health status, use of health care services, health care costs. In addition, this study will provide a detailed picture of the impact of risky drinking on the use of services by separately analyzing services to treat the adverse medical consequences of alcohol consumption, alcohol abuse and dependence treatment, other medical care (not related to alcohol consumption), and preventive service use. The research questions will be addressed using data from several data sources including data from a large study that screened primary care patients about their alcohol consumption. The specific aims are: (1) to compare mortality and health status of risky drinkers with light-to-moderate drinkers over a five-year period; (2) to compare use of services to treat the adverse consequences of alcohol consumption, alcohol abuse and dependence treatment services, other medical services, and preventive services for risky and light-to-moderate drinkers over a five-year period (3) to compare patterns of health care cost for risky and light-to- moderate drinkers over a five-year period.